'Steep' tax rise for NHS

Tony Blair today headed a concerted Cabinet onslaught with a single message: Be ready for steep tax rises if you want a world class health service.

The Prime Minister told voters to prepare for pain in Gordon Brown's Budget this spring with a bleak warning that the country is going to have to stump up as never before.

He said: "In this forthcoming Budget, there will be a tough choice, not just for politicians but for the country. If we want sustained investment in the National Health service over a period of time, we are going to have to pay for it."

That message will be rammed home today by Health Secretary Alan Milburn, who will tell 600 NHS bosses at a conference in London that Britain can no longer have its healthcare on the cheap.

A spokesman for Mr Milburn said the message would be that "people cannot have their cake and eat it". He added: "If they want an NHS that is world class, they have got to appreciate that. We have had healthcare on the cheap in this country for too long."

But it is clear that his message was also aimed at the country as a whole, at a time when there is growing public discontent over waiting lists, the state of the casualty departments and the lack of care for the elderly.

The steep rises in taxation needed to secure investment of several billion pounds in the NHS could come through higher national insurance charges. Labour has ruled out any increase in the basic or higher rate of tax.

Gordon Brown first raised the prospect of tax rises last autumn, but Mr Blair's comments show his personal determination to secure investment in the NHS.

The Prime Minister ruled out any suggestion that a Labour government would bring in a social insurance health system, as seen in France and Germany, but he also indicated that the Government was prepared to pay more for key staff such as nurses, although the public sector has seen wages rise at twice the rate of the private sector over the last year.

Reducing waiting times is the top priority of both the Government and the public, but there is also concern over the rate of re-admissions into hospitals as too many patients are leaving hospital before they are fully recovered, and then are having to go back for more treatment.

The NHS chairmen were expected to tell Mr Milburn at the conference in London that the pressure on hospital beds remains very high because of the number of elderly patients, who cannot be discharged as there are too few nursing homes to accommodate them.

The Prime Minister made his comments after receiving a letter from the leaders of public services in London - revealed in the Evening Standard yesterday - which warned that staff morale was at an all-time low.

In his reply to that letter, Mr Blair conceded that the Government had to "do more on pay" for public servants, describing them as the "lifeblood of the country".

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